Terapia fotodinâmica para ação bactericida em úlceras venosas de usuários do serviço público de saúde / Photodynamic therapy for bactericidal action on venous ulcers of users of public health service

Introdução: As úlceras de difícil cicatrização caracterizam-se como uma patologia que afeta cerca de 20 milhões de pessoas pelo mundo. A terapia fotodinâmica TFD é um método que atua nas fases da cicatrização, bioestimulando o tecido e promovendo a morte dos microorganismos Objetivo: O objetivo deste estudo foi avaliar a TFD como técnica de ação bactericida na cicatrização das úlceras de usuários de um serviço público de saúde acometidos por úlceras venosas UV. Métodos: Para avaliar a presença de bactérias nas úlceras, foi utilizado um swab stuart. Foi aplicado o medicamento à base de curcumina na úlcera e a mesma foi imediatamente ocluída com papel alumínio durante 20 minutos. Resultados: Durante todo período de coleta houve crescimento de bactérias nas úlceras. Os participantes obtiveram redução da área das úlceras, avaliadas pela quantificação do software Image J Conclusão: A TFD foi capaz de acelerar o tempo de cicatrização de úlceras venosas, ao efeito bactericida, a técnica carece ainda de mais estudos.

Introduction: Ulcers that are difficult to heal are characterized as a pathology that affects about 20 million people around the world. PDT photodynamic therapy is a method that acts in the healing phases, biostimulating the tissue and promoting the death of microorganisms affected by UV. Methods: To assess the presence of bacteria in the ulcers, a stuart swab was used. the medicine based on curcumin was applied to the ulcer and it was immediately occluded with aluminum foil for 20 minutes. Results: During the entire collection period, there was growth of bacteria in the ulcers. The participants obtained a reduction in the area of the ulcers, evaluated by the quantification of the Image J software. Conclusion: PDT was able to accelerate the healing time of venous ulcers, due to its bactericidal effect, the technique still needs further studies.

Plant extract incorporated into glass ionomer cement as a photosensitizing agent for antimicrobial photodynamic therapy on Streptococcus mutans.

BACKGROUND: A plant extract (EB) incorporated into glass ionomer cement (GIG) could be a potential photosensitizer for Antimicrobial PDT (aPDT) against caries-microorganisms, replacing methylene blue (MB), due to the presence of chlorophyll. GIC + EB + aPDT could be an therapeutic alternative to dentin decontamination and sealing, allowing reduction of operative time. OBJECTIVE: Evaluate Dioscorea altissima (EB) incorporated into GIC as a photosensitizer for aPDT against Streptococcus mutans. METHODS: Groups (n = 24; ntotal = 192): G1-GIC; G2-GIC + LASER; G3-GIC/EB; G4-GIC/EB + LASER; G5-GIC+MB; G6-GIC + aPDT; G7-GIC/EB + MB; and G8 - GIC/EB+aPDT. In aPDT groups, MB was the photosensitizer. In LASER groups, MB was not used. The irradiation protocol was 660 nm/100 mW/5 J/150 J/cm²/50 s, with a 5-min pre-irradiation time for the MB groups. Antibacterial assays were carried out in 24-well microplates. The wells were completed with one milliliter of a S. mutans in BHI at 1.3 × 108 CFU/mL suspension. After incubation, PDT or laser was performed. After MTT bacteria viability test, the data were submitted to the Kolgomorov-Smirnoff normality test, followed by one-way ANOVA and Tukey's posterior test, α < 0.05. RESULTS: Group G6 showed significant inhibition (p < 0.001), followed by groups G4, G5, G7, and G8, which did not show significant differences among them (p > 0.05). Groups G2 and G3 also showed similar results (p > 0.05) and were the least active compared to the others. CONCLUSIONS: EB potentiated the antimicrobial action of GIC against S. mutans and laser irradiation over GIC/EB presented better antimicrobials results. The results indicate that EB could be a potential photosensitizer for aPDT.

Comparison of photobiomodulation in the treatment of skin injury with an open wound in mice.

This study aimed to investigate the effects of photobiomodulation at a wavelength of 660 and 830 nm at different numbers of application points in the healing of open wounds in mice. In total, 120 mice were divided into 10 groups. The animals were submitted to cutaneous lesion of the open wound type (1.5 × 1.5 cm). Photobiomodulation at a wavelength of 660 and 830 nm and total energy of 3.6 J were used, applied at 1, 4, 5, and 9 points, for 14 days. The animals were subjected to analysis of the lesion area, skin temperature, and histological analysis. Macroscopic analysis results showed a difference (p < 0.05) between the irradiated groups and the sham group at 14 days PO. There was no statistical difference in skin temperature. Histological analysis findings showed better results for the epidermis thickness. Regarding the number of blood vessels, a difference was found between the 1- and 5-point 830-nm photobiomodulation groups and between the 4-point 660-nm group and the naive group. A significant difference in the number of fibroblasts was observed between the 830- and 660-nm photobiomodulation groups and the naive and sham groups. When comparing photobiomodulation wavelength, the 830-nm groups were more effective, and we emphasize the groups irradiated at 5 points, which showed an improvement in macroscopic analysis and epidermis thickness, an increase in the number of vessels, and a lower number of fibroblasts on the 14th day after skin injury.

Associação de luz intensa pulsada e laser Erbium: Yag 2940nm para tratamento de lentigo na face / Association of intense pulsed light and Erbium: Yag 2940 nm laser for treatment of lentigo on the face

O lentigo solar está presente em 90% da população com mais de 50 anos de idade, apresentando-se como manchas hipercrômicas em regiões fotoexpostas, que aumentam com o envelhecimento e são mais frequentes em peles claras. Há diversas modalidades terapêuticas com melhores resultados quando associadas. Descrevemos o caso de um homem de 62 anos, fototipo II de Fitzpatrick, com queixa de máculas acastanhadas em dorso nasal há oito anos. Foi submetido à biópsia de pele, e o estudo histológico confirmou ser lentigo solar. O paciente foi tratado com seis sessões de luz intensa pulsada associada a laser de Erbium: YAG 2940nm, com bom resultado clínico

Solar lentigo is present in 90% of the population over 50 years of age andcharacterizes as hyperchromic spots in photoexposed regions. It increases with aging and is more frequent in light skin. There are several therapeutic modalities, which achieve better results whenassociated. We describe the case of a 62-year-old man with Fitzpatrick skinphototype II, complaining of brownish macules in nasal dorsum for eight years. The patient underwent a skin biopsy, and the histological study confirmed solar lentigo. The patient was treated with six sessions of Intense Pulsed Light associated with Erbium-Yag2940 nm Laser with a good clinical result

Photobiomodulation therapy in knee osteoarthritis reduces oxidative stress and inflammatory cytokines in rats.

Knee osteoarthritis (OA) is a chronic disease that causes pain and gradual degeneration of the articular cartilage. In this study, MIA-induced OA knee model was used in rats to test the effects of the photobiomodulation therapy (PBM). We analyzed the inflammatory process (pain and cytokine levels), and its influence on the oxidative stress and antioxidant capacity. Knee OA was induced by monosodium iodoacetate (MIA) intra-articular injection (1.5 mg/50 µL) and the rats were treated with eight sessions of PBM 3 days/week (904 nm, 6 or 18 J/cm2 ). For each animal, mechanical and cold hyperalgesia and spontaneous pain were evaluated; biological analyses were performed in blood serum, intra-articular lavage, knee structures, spinal cord and brainstem. Cytokine assays were performed in knee, spinal cord and brainstem samples. The effects of the 18 J/cm2 dose of PBM were promising in reducing pain and neutrophil activity in knee samples, together with reducing oxidative stress damage in blood serum and spinal cord samples. PBM improved the antioxidant capacity in blood serum and brainstem, and decreased the knee pro-inflammatory cytokine levels. Our study demonstrated that PBM decreased oxidative damage, inflammation and pain. Therefore, this therapy could be an important tool in the treatment of knee OA.

Effects of photobiostimulation in the treatment of post-herpetic neuralgia: a case report / Efeitos da fotobioestimulação no tratamento da neuralgia pós-herpética: relato de caso

Abstract Objectives: to describe the effect of photobiomodulation therapy in the treatment of post-herpetic neuralgia in the elderly. Case report: a female patient, 61 years old, 56 kg, 1.67cm tall, sought treatment at the Laser Therapy Center of the Universidade do Vale do Paraíba, in the city of São José dos Campos, São Paulo, Brazil, on October 27, 2015. She had been diagnosed with herpes zoster on September 4, 2015 with complaints of intermittent neuralgia in the long thoracic nerve path and spikes of intense pain (level 10, according to the analogue pain scale). Photobiomodulation was performed with low intensity laser spot irradiations at 20 points around the herpesvirus nerve, with a distance of 2cm between each point. Irradiation was performed at each point after 20 seconds, with 3J/cm2 per point and total energy of 60 J. At the end of the treatment the pain level was 0 and the patient exhibited a normal sleep pattern (8 hours of sleep). Conclusions: Photobiomodulation treated painful discomfort, improved the quality of life of the patient and proved to be an effective, safe and promising treatment, with significant potential to become the therapy of choice in such cases. AU

Resumo Objetivo: Descrever o efeito da fotobiomodulação no tratamento de neuralgia pós-herpética em idosa. Relato de caso: Paciente do gênero feminino, 61 anos, 56kg, 1,67cm de altura, procurou o Centro de Laserterapia da Universidade do Vale do Paraíba, na cidade de São José dos Campos, SP, Brasil, no dia 27 de outubro de 2015. Diagnosticada com herpes zoster em 4 de setembro de 2015 com queixas de neuralgia intermitente no trajeto do nervo torácico longo e picos de dor intensa (nível 10, segundo escala analógica de dor). A fotobiomodulação foi realizada com irradiações pontuais do laser de baixa intensidade em 20 pontos ao redor do nervo acometido pelo herpesvírus, com uma distância de 2 cm de cada ponto. A irradiação foi realizada com o tempo de 20 segundos em cada ponto, ou seja, 3J/cm2 por ponto e energia total de 60 J. Sendo ao final do tratamento o nível de dor 0 e o padrão de sono normal (oito horas de sono). Conclusão: A fotobiomodulação tratou o desconforto álgico, melhorou a qualidade de vida da paciente e mostrou-se, por meio de suas vantagens, ser um tratamento efetivo, seguro e promissor, com grande potencial de se tornar a terapia de escolha em tais casos. AU

Effectiveness of Low-Intensity Laser Therapy on Tissue Repair Following Saphenectomy in Patients Who Underwent Coronary Artery Bypass Graft: A Randomized, Double-Blind Study.

OBJECTIVE: To verify the effectiveness of low-intensity laser therapy (LLLT) on tissue repair following saphenectomy during postoperative period in patients having undergone coronary artery bypass graft (CABG). MATERIALS AND METHODS: A randomized clinical trial, controlled and double-blind study was conducted with 40 volunteers, divided into 2 groups: a placebo group (PG, n = 20) and a laser group (LG, n = 20). The patients in the LG group were irradiated with laser during saphenectomy (InGaAlP, λ 660 nm, energy density 6 J/cm2) daily from the first to the fourth postoperative day. The surgical incision was clinically evaluated and imaged at the beginning and at the end of the treatment. The areas of hematoma and hyperemia were evaluated using the software ImageJ 1.4©, and border closure was evaluated by three researchers, who were blinded concerning the allocation of the participants. RESULTS: The LG group presented a reduction of the areas of hematoma and hyperemia (p = 0.0003) and better border closure (p = 0.009), when compared with the PG group. CONCLUSIONS: The proposed LLLT protocol improved the tissue repair following saphenectomy in CABG patients.

Low-intensity laser (660 nm) on sternotomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study.

The aim of this study was to analyze the healing effects of low-level laser therapy (LLLT) on the longitudinal sternotomy incisions of patients who underwent coronary artery bypass graft (CABG). The volunteers were randomized into three groups of equal size (n = 30): control, placebo, and laser (λ = 660 nm and spatial average energy fluency [SAEF] = 1.06 J/cm2). The patients in the laser group underwent irradiation on postoperative days 2, 4, 6, and 8, and their sternotomy incisions were photographed immediately after the surgery and 8 days later for analysis. Three researchers who were blinded to the patient treatment groups analyzed the incision photographs to assess hyperemia and wound closure on the day of hospital discharge (eighth postoperative day). The sternotomy incisions in the LLLT group demonstrated less hyperemia, incisional bleeding, and dehiscence (p ≤ 0.005).

Experimental tooth movement and photobiomodulation on bone remodeling in rats.

Photobiomodulation (PBM) is a therapy induced by a specific type of laser that affects biologic systems through non-thermal ways. The study of its basic mechanism has gained interest since little is known about the causes of the different effects of this treatment. In the present study, we investigated the action of the PBM application rate changes in the peri-implant tissues in rats subjected to tooth movement in different periods. Wistar rats (±250 g) received an apparatus in the region of the central incisors superiors tightly (70 g) or not, and they were also subjected to one or three PBM sessions. After 7 or 14 days, the rats were subjected to euthanasia and the jaws were dissected and processed for histology. For analysis, serial sections were made that were stained by Picrosirius Red for analysis of collagen fibers, Masson's trichrome for newly formed bone scan, and Hematoxylin-Eosin for quantification of osteoblasts. PBM applied in one or three sessions increased the population of osteoblasts. Still, the application of three sessions of PBM increased the density of collagen fibers and new bone formation compared to the controls. An increase was observed in the interincisal distance in irradiated groups with three PBM sessions and the application of force for both 7 or 14 days. These findings suggest that PBM can contribute positively to the orthodontic movement. So the laser therapy can be used as an adjunct procedure to be performed concurrently for orthodontic treatment in the dental clinic.

Tratamento da neuralgia pós-herpética com irradiações a laser de baixa intensidade: revisão da literatura / Treatment of postherpetic neuralgia with low-level laser irradiation: literature review

OBJETIVOS: Realizar uma revisão da literatura sobre o tratamento da neuralgia pós-herpética com irradiações a laser de baixa intensidade. MÉTODOS: A revisão foi realizada nos meses de novembro a dezembro de 2015 nas bases de dados LILACS, SciELO e Medline, utilizando-se os descritores "herpes zoster", "neuralgia" e "terapia a laser de baixa intensidade" e seus correspondentes termos em inglês. Os critérios de inclusão foram artigos disponíveis na íntegra, publicados em português, inglês, alemão ou espanhol, no período compreendido entre 2008 a 2015. Os critérios de exclusão foram textos incompletos, artigos que não abordaram diretamente a temática do estudo e repetição de um mesmo artigo na mesma ou em diferentes bases de dados, nesse caso sendo considerado apenas um deles. RESULTADOS: A partir dos descritores utilizados foram encontrados 32 estudos. Após aplicação dos critérios de elegibilidade foram selecionados 15 artigos para leitura, dos quais foram excluídos dois por repetição e um por não apresentar resultados relevantes a esta pesquisa. Dessa forma, 11 estudos foram incluídos na revisão, dos quais cinco foram realizados nos Estados Unidos, dois no Brasil, dois na Alemanha e dois na Itália, sendo quatro ensaios clínicos, duas revisões sistemáticas e cinco relatos de casos. Os 11 estudos encontraram resultados positivos após aplicação do laser, principalmente diminuição da dor, e apenas um artigo mencionou pouca redução da neuralgia. Nos três estudos que informaram os parâmetros de irradiação estes não foram uniformes, sendo a média do comprimento de onda 740,6 nm, a média da potência 28 mW e a média do tempo de irradiação por ponto 53,4 segundos. Quanto ao número de sessões, houve grande variação, com uma média de aproximadamente 12 sessões em dia alternados. CONCLUSÕES: A terapia com laser de baixa intensidade ofereceu resultados positivos aos pacientes com neuralgia pós-herpética, entretanto não há um consenso quanto aos parâmetros a serem utilizados. Em razão dos diferentes protocolos descritos, é importante realizar mais estudos que auxiliem a padronizar os parâmetros dessa terapia aplicados à neuralgia pós-herpética.

AIMS: To perform a literature review on the treatment of postherpetic neuralgia with low-intensity laser irradiation. METHODS: The review was conducted in November and December 2015 by searching the terms "herpes zoster", "neuralgia", "low-level laser therapy", and "low-intensity laser therapy" in the LILACS, SciELO, and Medline databases. Full articles published in Portuguese, English, German, or Spanish between 2008 and 2015 were included. Incomplete articles, those that did not directly address the topic of interest, and those appearing in the same or in different databases were excluded. In the latter case, only one article was included. RESULTS: Thirty-two studies were selected using the search terms. After the application of the eligibility criteria, 15 studies were read; two of them were excluded for being available in more than one database and one was eliminated for not adding relevant information. Therefore, 11 studies were included in the review: five of them conducted in the United States, two in Brazil, two in Germany, and two in Italy. There were four clinical trials, two systematic reviews and five case reports. The 11 studies found positive results after laser application, especially reduction of pain, with only one article mentioning little reduction of neuralgia. In the three studies that reported the irradiation parameters, these have not been uniform, with a medium wavelength of 740.6 nm, a medium power of 28 mW and a medium time of irradiation per point of 53.4 seconds. There was great variation in the number of sessions, with an average of about 12 sessions on alternate days. CONSLUSIONS: The low-intensity laser therapy provided positive results to patients with postherpetic neuralgia, however there is no consensus about the parameters to be used. In view of the different protocols, it is important to perform new studies in order to standardize the lowintensity laser therapy parameters applied to postherpetic neuralgia.

Efeitos da fotobiomodulação nas alterações extrapulmonares ocasionadas pelo enfisema experimental em rattus norvegicus / Effect of photobiomodulation in extrapulmonary changes caused by experimental emphysema in rattus norvegicus

O enfisema pulmonar é um processo inflamatório pulmonar e tem repercussões extrapulmonares. Os objetivos desta pesquisa são investigar os efeitos da fotobiomodulação nas alterações extrapulmonares. Foram selecionados 24 ratos, divididos em três grupos de 8 animais: grupo controle (GC: recebeu apenas solução salina); grupo DPOC (GD: instilação de papaína 2 mg/kg); grupo DPOC + laser (GDL: instilação de papaína + 15 dias de laserterapia). Para análise dos dados foi coletado e observado: CKMB, LBA, Histologia (análise morfométrica) e espessura das câmaras cardíacas (análise morfométrica), respectivamente. Houve diminuição no número de células inflamatórias no LBA do GDL (p < 0,05) quando comparado com GC e GD; aumento dos níveis de CKMB no grupo GD (p < 0,05); e diminuição significativa no GDL (p = 0,0009) quando comparado com o GD, hipertrofia ventricular esquerda (p < 0,05) no grupo GD e GDL quando comparado com controle. A fotobiomodulação diminui a liberação de células inflamatórias responsáveis pela liberação do CKMB na corrente sanguínea, diminuindo assim os níveis de CKMB e reduzindo os riscos de infarto do miocárdio.

Lung emphysema is a pulmonary inflammatory process, with extrapulmonary repercussions. Twenty-four rats were selected and divided into three groups with eight animals each: control (GC: received only saline solution); group DPOC (GD: with instillation of papaya proteinase 2 mg/kg); group DPOC + laser (GDL: with instillation of papaya proteinase + 15 days of laser therapy). Data analysis comprised: CKMB, LBA, Histology (morphometric analysis) and thickness of the cardiac chambers (morphometric analysis), respectively. The number of inflammatory cells in LBA of GDL decreased (p < 0.05) when compared with GC and GD; there was an increase in CKMB levels in group GD (p < 0.05); significant decrease in GDL (p = 0.0009) when compared to GD, left ventricle hypertrophy (p < 0.05) in group GD and GDL when compared to control. Photobiomodulation decreased the release of inflammatory cells by the release of CKMB in the blood and decreased CKMB levels and reduced myocardial infarction risks.

Effects of a Low-Intensity Laser on Dental Implant Osseointegration: Removal Torque and Resonance Frequency Analysis in Rabbits.

The objective of this study was to investigate how a low-intensity laser affects the stability and reverse torque resistance of dental implants installed in the tibia of rabbits. Thirty rabbits received 60 dental implants with the same design and surface treatment, one in each proximal metaphysis of the tibia. Three groups were prepared (n = 10 animals each): conventional osseointegration without treatment (control group), surgical sites irradiated with a laser beam emitted in the visible range of 680 nm (Lg1 group), surgical sites irradiated with a laser beam with a wavelength in the infrared range of 830 nm (Lg2 group). Ten irradiation sessions were performed 48 hours apart; the first session was during the immediate postoperative period. Irradiation energy density was 4 J/cm(2) per point in 2 points on each side of the tibias. The resonance frequency and removal torque values were measured at 2 time points after the implantations (3 and 6 weeks). Both laser groups (Lg1 and Lg2) presented a significant difference between resonance frequency analysis values at the baseline and the values obtained after 3 and 6 weeks (P > .05). Although the removal torque values of all groups increased after 6 weeks (P < .05), both laser groups presented greater mean values than those of the control group (P < .01). Photobiomodulation using laser irradiation with wavelengths of 680 and 830 nm had a better degree of bone integration than the control group after 6 weeks of observation time.

Vestibuloplastia con láser: Reporte de caso / Laser vestibuloplasty: Case report

En pacientes edéntulos totales, uno de los desafíos para rehabilitación bucal es la confección de prótesis en un reborde alveolar con avanzada resorción ósea, lo que hace necesario realizar cirugías preprotésicas que preparen las bases óseas y los tejidos blandos circundantes para recibir la prótesis mucosoportada, brindando retención y adecuado soporte; además de generar menor cantidad de trauma posible, permitiendo la pronta cicatrización tisular. Se presenta el caso de mujer de 56 años, sin antecedentes médicos relevantes. Refiere portar prótesis totales desde hace 14 años, las cuales se encuentran desadaptadas. Al examen clínico intraoral se observan rebordes colapsados y reabsorbidos. Debido a la falta de retención en los rebordes inferiores, se realizó cirugía de profundización del vestíbulo con láser. Se obtiene a los 18 días tejido completamente cicatrizado, con una recuperación en profundidad del vestíbulo de 6 mm en sector anterior y 4 mm en posterior. Finalmente se rehabilita con prótesis total bimaxilar. Se concluye que la vestibuloplastia láser permite profundizar el vestíbulo y ofrece las ventajas de la incisión láser que disminuye la hemorragia, brinda mejor campo operatorio, disminuye la inflamación y el dolor postoperatorio.

One of the greatest challenges when rehabilitating fully edentulous patients, is to manufacture a denture to be placed on an alveolar ridge with advanced bone resorption. This requires performing pre-prosthetic surgery and prepare groundwork bone and surrounding soft tissues to receive a tissue-borne prosthesis, as well as providing suitable retention and support. This will elicit lesser trauma and thus allow prompt tissue healing. The case here presented is that of a 56 year old female, with non-contributory medical history. The patient had been wearing dentures for the last 14 years; her dentures were ill-adapted. Intra-oral clinical examination revealed collapsed and re-absorbed ridges. Due to a lack of retention in the lower ridges, a laser surgery was performed to deepen the vestibule. 18 days after surgery tissues were completely healed, the vestibule had recovered 6 mm depth in the anterior section and 4 mm in the posterior section. Rehabilitation was completed with the manufacture of full bi-maxillary dentures. It was thus concluded that laser vestibuloplasty confers depth to the vestibule and offers the advantages of laser incision, which decreases hemorrhage, provides better operating field and reduces post-operative inflammation and pain.

Low-intensity laser therapy and led (light emitting diode) therapy in mechanical resistance of Rattus norvegicus chest inscision with implant of steel wire for sternal suture

INTRODUCTION: Low-intensity laser (LILT) and LED therapy are indicated in repairing surgical incisions, which occur in cardiac surgery. One major concern in this case is the presence of metallic wire used for sternal sutures, its temperature may rise while using a laser or LED. This study aimed to analyze the tensiometric properties of the skin tissue with longitudinal incision and metallic wire implant used for sternal suture irradiated with LILT and LED. METHODS: Twenty-five subjects (Rattus norvegicus) were submitted to thoracic incision with implantation of metallic wire, and subsequently divided into five groups: GI (control group); GII (laser group 6J/cm²); GIII (laser group 10J/cm²); GIV (LED group 6 J/cm²); and GV (LED 10J/cm²). Photobiomodulation was performed on a daily basis for eight consecutive days and the local temperature was measured before and after phototherapy. After euthanasia the tissues were subjected to tensiometric and histological analysis. RESULTS: All irradiated groups showed increase in break strength (p = 0.009), and decrease in tissue deformation strength compared with the control group (p = 0.03). CONCLUSION: Both LILT and LED can promote wound healing at the tested doses with increased tissue resistance, although its elasticity is reduced. The imprecision of the assessing instruments precluded an accurate measurement of a possible local tissue heating post irradiation and future studies are need to elucidate this effect.

Cicatrização de feridas decorrentes da hanseníase utilizando laser de baixa intensidade / Wound healing leprosy induced by low intensity laser

A hanseníase é causada pelo bacilo Mycobacterium leprae(M. leprae), apresentando grande capacidade de infectar vários indivíduos com contágio pelas vias aéreas superiores. A hanseníase considerada um problema de saúde pública, principalmente nos países subdesenvolvidos e nos em desenvolvimento, devido à presença de incapacidades e estigma social...

Leprosy is caused by the bacillus Mycobacterium leprae(M. leprae), presenting the capacity to infect multiple individuals with infection of the upper airways. Hansen considered a public health problem, especially in under developed countries and developing countries, due to the presence of disabilities and social stigma...

Laser terapêutico no reparo ósseo de ratos submetidos à ausência de carga / Laser therapy on bone repair of rats submitted weightlessness / Láser Terapéutico En Reparación De Hueso De Ratones Sometidos A La Ausencia De Carga

Laser de baixa intensidade tem sido utilizado como agente físico em várias áreas das ciências médicas, como para reparo ósseo e tecidual. Entretanto, pouco se sabe sobre seus efeitos em condições adversas como a supressão de carga e osteopenia. Com a hipótese de que o laser Ga-Al-As acelera o processo de consolidação óssea, foi objetivo deste estudo avaliar a densidade mineral óssea (DMO), em osteotomias transversais incompletas em tíbias de ratos Wistar, adultos, tratados com laser terapêutico de baixa potência em três diferentes grupos: G1 (n=10), referência 15 dias; G2 (n=10), suspenso pela cauda e, concomitantemente, tratados com laser por 12 dias; G3 (n=10), suspenso pela cauda por 36 dias sendo que, após o 21º dia, iniciou-se tratamento com laser por 12 dias. A tíbia direita foi tratada com laser e a esquerda serviu de controle. O laser utilizado foi de Ga-Al-As, DMC - Flash Lase III®, com comprimento de onda 830nm, 100 mW, 4J, 140 J/cm², 40s de aplicação em 12 sessões. Utilizou-se densitômetro DPX-Lunar®, com programa computacional para pequenos animais, e a análise da DMO foi feita no osso todo e na região da osteotomia. Os resultados não demonstraram eficácia da terapia laser no processo de reparação óssea, tanto nos animais do grupo1, quanto nos do grupo 2 e 3. Conclui-se que ou o laser de baixa potência não teve uma atuação eficaz ou os efeitos da terapia laser se manifestaram não só no local da irradiação como também a nível sistêmico.

Low-intensity laser has been used as a physical agent in various fields of medical sciences such as bone and tissue repair. Meanwhile little is known about its effects in adverse conditions such as abolition of load and osteopenic. With the assumption that the laser Ga- Al-As accelerates the process of bone consolidation, goal of this study was to evaluate bone mineral density (BMD) in incomplete transverse osteotomies of tibia in adult rats, treated with low power laser therapy in three different groups: G1 (n = 10), reference 15 days; G2 (n=10), suspended by the tail and, accordingly, treated with laser for 12 days; G3 (n = 10), suspended by the tail by 36 days and that after 21 days, there was laser treatment for 12 days. The right tibia treated with laser and left served as control. The laser was used to Ga-Al-As, DMC - Flash Lase® III, with wavelength 830nm, 100 mW, 4J, 140 J / cm ², 40s of application in 12 sessions. It was used densitometer-Lunar DPX®, with computer program for "small animals", and the analysis of BMD was made in the bone throughout the region and the osteotomy. The results showed no efficacy of laser therapy in the process of bone repair, both in animals of group 1, as in group 2 and 3. It follows that either the low-power laser was not an effective performance or the effects of laser therapy is not only manifested at the site of irradiation as well as the systemic level.

Láser e baja intensidad se ha utilizado como agente físico en diversos campos de las ciencias médicas, para reparar huesos y tejidos. Mientras tanto, poco se sabe sobre sus efectos en condiciones adversas como la supresión de la carga y osteopenia. En el supuesto de que el láser Ga-Al-As acelera el proceso de consolidación ósea, el objetivo de este estudio fue evaluar la densidad mineral ósea (DMO) en osteotomías transversal incompletas de la tibia de ratones Wistar, adultos, tratados con la terapia láser de baja potencia en tres diferentes grupos: G1 (n = 10), la referencia 15 días; G2 (n = 10), suspendido por la cola y, en consecuencia, tratados con láser durante 12 días, G3 (n = 10), suspendido por la cola durante 36 días, mientras , que después de 21 días, se inició tratamiento con láser durante 12 días. La tibia derecha fue tratada con el láser y la izquierda sirvió como control. El láser utilizado fue Ga-Al-As, DMC - Lase Flash®III, con longitud de onda de 830nm, 100 mW, 4J, 140 J / cm², 40 segundos de aplicación en 12 sesiones. Se usó el método de densitómetro Lunar DPX®, con el programa de ordenador para los pequeños animales, y el análisis de la DMO se hizo en el hueso todo y en la región de osteotomía. Los resultados no mostraron la eficacia de la terapia con láser en el proceso de reparación ósea, tanto en animales de grupo 1, como en losgrupos 2 y 3. Se concluye que o bien el láser de baja potencia no tuvo un desempeño eficaz o los efectos de la terapia con láser no sólo se manifiestan en el lugar de la irradiación, así como el nivel sistémico.

Laser terapêutico no reparo ósseo de ratos submetidos à ausência de carga / Laser therapy on bone repair of rats submitted weightlessness / Láser Terapéutico En Reparación De Hueso De Ratones Sometidos A La Ausencia De Carga

Laser de baixa intensidade tem sido utilizado como agente físico em várias áreas das ciências médicas, como para reparo ósseo e tecidual. Entretanto, pouco se sabe sobre seus efeitos em condições adversas como a supressão de carga e osteopenia. Com a hipótese de que o laser Ga-Al-As acelera o processo de consolidação óssea, foi objetivo deste estudo avaliar a densidade mineral óssea (DMO), em osteotomias transversais incompletas em tíbias de ratos Wistar, adultos, tratados com laser terapêutico de baixa potência em três diferentes grupos: G1 (n=10), referência 15 dias; G2 (n=10), suspenso pela cauda e, concomitantemente, tratados com laser por 12 dias; G3 (n=10), suspenso pela cauda por 36 dias sendo que, após o 21º dia, iniciou-se tratamento com laser por 12 dias. A tíbia direita foi tratada com laser e a esquerda serviu de controle. O laser utilizado foi de Ga-Al-As, DMC - Flash Lase III®, com comprimento de onda 830nm, 100 mW, 4J, 140 J/cm², 40s de aplicação em 12 sessões. Utilizou-se densitômetro DPX-Lunar®, com programa computacional para pequenos animais, e a análise da DMO foi feita no osso todo e na região da osteotomia. Os resultados não demonstraram eficácia da terapia laser no processo de reparação óssea, tanto nos animais do grupo1, quanto nos do grupo 2 e 3. Conclui-se que ou o laser de baixa potência não teve uma atuação eficaz ou os efeitos da terapia laser se manifestaram não só no local da irradiação como também a nível sistêmico.(AU)

Low-intensity laser has been used as a physical agent in various fields of medical sciences such as bone and tissue repair. Meanwhile little is known about its effects in adverse conditions such as abolition of load and osteopenic. With the assumption that the laser Ga- Al-As accelerates the process of bone consolidation, goal of this study was to evaluate bone mineral density (BMD) in incomplete transverse osteotomies of tibia in adult rats, treated with low power laser therapy in three different groups: G1 (n = 10), reference 15 days; G2 (n=10), suspended by the tail and, accordingly, treated with laser for 12 days; G3 (n = 10), suspended by the tail by 36 days and that after 21 days, there was laser treatment for 12 days. The right tibia treated with laser and left served as control. The laser was used to Ga-Al-As, DMC - Flash Lase® III, with wavelength 830nm, 100 mW, 4J, 140 J / cm ², 40s of application in 12 sessions. It was used densitometer-Lunar DPX®, with computer program for "small animals", and the analysis of BMD was made in the bone throughout the region and the osteotomy. The results showed no efficacy of laser therapy in the process of bone repair, both in animals of group 1, as in group 2 and 3. It follows that either the low-power laser was not an effective performance or the effects of laser therapy is not only manifested at the site of irradiation as well as the systemic level.(AU)

Láser e baja intensidad se ha utilizado como agente físico en diversos campos de las ciencias médicas, para reparar huesos y tejidos. Mientras tanto, poco se sabe sobre sus efectos en condiciones adversas como la supresión de la carga y osteopenia. En el supuesto de que el láser Ga-Al-As acelera el proceso de consolidación ósea, el objetivo de este estudio fue evaluar la densidad mineral ósea (DMO) en osteotomías transversal incompletas de la tibia de ratones Wistar, adultos, tratados con la terapia láser de baja potencia en tres diferentes grupos: G1 (n = 10), la referencia 15 días; G2 (n = 10), suspendido por la cola y, en consecuencia, tratados con láser durante 12 días, G3 (n = 10), suspendido por la cola durante 36 días, mientras , que después de 21 días, se inició tratamiento con láser durante 12 días. La tibia derecha fue tratada con el láser y la izquierda sirvió como control. El láser utilizado fue Ga-Al-As, DMC - Lase Flash®III, con longitud de onda de 830nm, 100 mW, 4J, 140 J / cm², 40 segundos de aplicación en 12 sesiones. Se usó el método de densitómetro Lunar DPX®, con el programa de ordenador para los pequeños animales, y el análisis de la DMO se hizo en el hueso todo y en la región de osteotomía. Los resultados no mostraron la eficacia de la terapia con láser en el proceso de reparación ósea, tanto en animales de grupo 1, como en losgrupos 2 y 3. Se concluye que o bien el láser de baja potencia no tuvo un desempeño eficaz o los efectos de la terapia con láser no sólo se manifiestan en el lugar de la irradiación, así como el nivel sistémico.(AU)

Influência de diferentes comprimentos de onda da laserterapia de baixa intensidade na regeneração tendínea do rato após tenotomia / Influence of different low-intensity laser therapy wavelengths for rat tendon regeneration following tenotomy

OBJETIVO: Comparar a influência da terapia laser baixa intensidade (TLBI) na organização das fibras de colágeno, na dose de 3J/cm² em dois comprimentos de onda (lambda) (670nm e 904nm) e na associação de ambos, durante o reparo do tendão calcâneo de ratos. MÉTODO Foram utilizadas 37 ratas da raça Wistar divididas em 5 grupos, submetidas a tenotomia total por meio de cisalhamento transversal do tendão na porção média entre a inserção calcânea e a junção miotendínea, com exceção do grupo GP (n= 6) que não houve lesão. O grupo GA (n= 8) foi submetido à irradiação laser lambda= 904nm, diodo de GaAs, emissão pulsada, duração do pulso de 180ns, freqüência de pulso de 2000Hz e potência de pico de 15W e dose de 3J/cm². O grupo GB (n= 8) foi submetido à irradiação laser lambda= 670nm, diodo de AlGaInP, emissão contínua, potência 30mW e dose de 3J/cm². O grupo GAB (n= 8) recebeu irradiação de ambos os lasers 670nm e 904nm associados. O grupo GCL (n= 7) foi submetido a um tratamento placebo, assim como um grupo padrão. Após um total de 12 sessões de laserterapia, os animais foram submetidos à eutanásia no 14º dia pós-operatório. Após processamento histológico padrão, foi realizada a quantificação do retardo óptico pela birrefringência. RESULTADOS: A análise estatística mostra que todos os grupos irradiados apresentaram valores de retardo óptico maiores quando comparados ao grupo placebo (p= 0,00001), o que indica que apresentaram melhor organização das fibras colágenas ao longo do eixo longitudinal do tendão, evidenciando melhor qualidade no reparo. O grupo GAB foi o que apresentou melhores resultados (p= 0,00001) quando comparado aos demais grupos, excetuando-se o GP, que é o referencial de retardo óptico para esta faixa etária.

OBJECTIVE: The aim of this study was to compare the effect of the low level laser therapy in the organization of the collagen fibers with 3 J/cm² of dose in two wavelengths (670nm and 904nm) and in the combination of both on the tissue repair of the calcaneus tendon. METHODS: We used 37 female Wistar rats divided in 5 groups which had been submitted to the total tenotomy. Group GA (n= 8) was submitted to the laser irradiation in lambda= 904nm, GaAS diode, pulsated emission, peak power 15W and dose of 3J/cm², group GB (n= 8) was submitted to laser irradiation lambda= 670nm AlGaInP diode, continuous emission, power 30 mW and dose 3J/cm², group GAB (n= 8) was submitted to association of both of lasers and group GCL (n= 7) which the calcaneum tendon was submitted to placebo treatment. The group GP (n= 6) was a standard group without lesion and treatment. The animals received 12 sessions of lasertherapy and submitted to euthanasia on 14th day after surgery. The tendons were submitted to histological procedure and were analyzed to evaluate the optic retardation (in nm) for the birefringence measurement. RESULTS: The statistic analysis showed that the irradiated groups have higher values of optic retardation statistically significant than placebo group (p= 0,00001). It indicates that all the treated groups show better organization of collagen fibers in the longitudinal axis of the tendon, evidencing better quality in the tissue repair. The group GAB was that shown best results (p= 0,00001) when compared to another groups.